Longitudinal associations between exclusive, dual, and polytobacco use and asthma among US youth

Authors

Delvon T. Mattingly, University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA. Electronic address: delvon@umich.edu.
Steven Cook, University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA.Follow
Jana L. Hirschtick, Advocate Aurora HealthFollow
Akash Patel, University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA.
Douglas A. Arenberg, University of Michigan Medical School, Division of Pulmonary and Critical Medicine, Department of Internal Medicine, Ann Arbor, MI 48109, USA.Follow
Geoffrey D. Barnes, University of Michigan, Center for Bioethics and Social Science in Medicine, Ann Arbor, MI 48109, USA; University of Michigan, Frankel Cardiovascular Center, Ann Arbor, MI 48109, USA.Follow
David T. Levy, Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC, USA.
Rafael Meza, University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA; BC Cancer Research Center, Department of Integrative Oncology, Vancouver, British Columbia, Canada.
Nancy L. Fleischer, University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI 48109, USA.

Recommended Citation

Mattingly DT, Cook S, Hirschtick JL, et al. Longitudinal associations between exclusive, dual, and polytobacco use and asthma among US youth. Prev Med. 2023;171:107512. doi:10.1016/j.ypmed.2023.107512

Abstract

Little is known about the respiratory health effects of dual (two products) and polytobacco (three or more products) use among youth in the United States. Thus, we followed a longitudinal cohort of youth into adulthood using data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study, examining incident asthma at each follow-up (Waves 2-5). We classified past 30-day tobacco use as 1) no products (never/former use), 2) exclusive cigarettes, 3) exclusive electronic nicotine delivery systems (ENDS), 4) exclusive other combustible (OC) tobacco products (cigars, hookah, pipe), 5) dual cigarettes/OC and ENDS, 6) dual cigarettes and OCs, and 7) polytobacco use (cigarettes, OCs, and ENDS). Using discrete time survival models, we analyzed the incidence of asthma across Waves 2-5, predicted by time-varying tobacco use lagged by one wave, and adjusted for potential baseline confounders. Asthma was reported by 574 of the 9141 respondents, with an average annual incidence of 1.44% (range 0.35% to 2.02%, Waves 2-5). In adjusted models, exclusive cigarette use (HR: 1.71, 95% CI: 1.11-2.64) and dual cigarette and OC use (HR: 2.78, 95% CI: 1.65-4.70) were associated with incident asthma compared to never/former use, while exclusive ENDS use (HR: 1.50, 95% CI: 0.92-2.44) and polytobacco use (HR: 1.95, 95% CI: 0.86-4.44) were not. To conclude, youth who use cigarettes with or without OCs had higher risk of incident asthma. Further longitudinal studies on the respiratory health effects of ENDS and dual/polytobacco use are needed as products continue to evolve.

Document Type

Article

PubMed ID

37054989